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Uzbekistan

A package of simple changes boosts child survival across Uzbekistan

NAMANGAN, Uzbekistan, 18 October 2010 – At the Namangan Children’s Multi-Profile Medical Centre in eastern Uzbekistan, early morning is the busiest time in the admissions department.

VIDEO: UNICEF reports on a package of health changes making strides in reducing Uzbekistan's child mortality rate.
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Parents and their children, some of them having traveled many kilometres overnight to get here, wait in turn to be seen. Amidst the cries of babies and the press of anxious parents, the staff prioritize cases efficiently and calmly.

In doing so, they are helped by a system of coloured ribbons which ensures that the most urgent cases are seen first. Nurse Yumrzakova Iroda explains the coding of green, yellow and red ribbons which are tied around the babies arms, with the red ribbon cases going to the front of the queue. These are babies considered critical, demanding urgent attention.

The coding system is part of a package of improvements under the country-wide ‘Integrated Management of Childhood Illnesses’ programme – or IMCI – being carried out by the Uzbekistan Ministry of Health, the European Commission and UNICEF. The programme has lead to a dramatic transformation in hospitals such as this one, and is having a real impact on child survival.

More effective, less stressful

Upstairs in the hospital’s Resuscitation Unit there is further evidence of change.

Mavluda, three months old, is treated at the Namangan Children’s Multi-Profile Medical Centre in eastern Uzbekistan.

Mavluda, three months, has just been admitted with breathing problems caused by a lung infection – but is now out of danger thanks to prompt intervention. Chief of the Resuscitation Department Dr. Aripov Alisher and his team give the baby oxygen and closely monitor him.

“Before we would have used intravenous injections,” explained Dr. Aripov. “But now we have been trained to give oral medicines, which are more effective and less stressful.”

Less invasive treatments and fewer prescribed drugs has also resulted in significant cost savings at hospitals such as this one, with reductions of up to 25 per cent.

Changing the system

One seemingly simple change – allowing mothers and babies to remain together during treatment – has helped to alleviate stress for mothers and babies alike. In the past, the parents would have been excluded during their child’s treatment.

Cuddling her five-month-old baby, Begim, young mother Akhmedova Muyassar told us she was allowed to stay with her baby throughout her treatment for the fever which was now passing. “I knew she was recovering,” she said, “when her smile returned.”

Babies and their parents in provinces throughout Uzbekistan are grateful for the changes taking place thanks to the IMCI programme. It is helping to promote infant and young child feeding, growth monitoring and newborn care at the community level. IMCI training has also been extended to doctors in hospitals, at primary care level and also in rural communities.

Chief Doctor at the Multi-Profile Medical Centre Dr. Rakhmanov Abdumalik explained the impact the system was having even in the country’s most remote rural areas. “During home visits, nurses give advice on things like exclusive breast feeding, nutrition and hygiene,” he said.

Greatly improved survival

To date, the results of the IMCI programme have been vast. There has been a reported drop in the number of diarrhoea cases coming for treatment.

At the nearby Infectious Disease Hospital, the number of children being admitted for diarrhoea also fell from around 9,000 in 1998 to fewer than 3,000 today – further proof that the IMCI programme is making strides in improving survival for children under five years old.